Mobile Computer-Mediated Assessment of Autism Risk By Non-Specialists in Home Settings: Insights from the START Project
Objectives: To conduct a proof-of-principle study with START, administered by non-specialist workers in and around Delhi, India, using a case control study design comprising three groups of children: those with autism spectrum disorders (ASD), intellectual disabilities (ID), or typically developing (TD) children.
Methods: Non-specialist workers tested 127 children with ASD (n=46), ID (n=38) and TD (n=43), aged 2-7 years in their homes. We present data on three sets of measures: (1) social motivation measured using a) preferential looking task: tablet-based eye-tracking to measure distribution of overt attention between a social and a non-social stimulus, and b) choice task: to measure preference for social rewards; (2) sensory interests were measured by showing children a video of a spinning wheel which they could stop at will; and (3) motor following task: where participants were asked to follow with their finger the trajectory of a butterfly moving in a predetermined random manner.
Results: (1) In the preferential gaze task, children with ASD spend significantly (Figure 1, top left) less time looking at the social stimuli than the TD group (F(2, 104) = 4.21, p = 0.017) but in the choice task (Figure 1, top right) the groups do not differ in their choice of the social stimulus (F(2, 98) = 0.58, ns). (2) Children with ASD spend significantly longer looking at a spinning wheel than TD (F(2, 81) = 19.57, p < .001). (3) Children with ASD execute the motor following task with significantly greater spatio-temporal mean squared errors than do TD or ID groups (F(2, 78) = 19.36, p < .001).
Conclusions: This study provides proof of principle for START, revealing the expected pattern of ASD-TD group differences in relevant tasks. It also demonstrates the feasibility of such mobile scalable testing of neurodevelopment by non-specialists in home settings.